#AGEMATTERS35 : Why Don’t Doctors Tell Patients That Age Matters ?

After listening to a news story from Australia about how fertility specialists are not telling over 40-year-old patients the real chances of having a child, I was disturbed to find out that added-on procedures to an IVF are being performed with absolutely no studies being tested to show that they work. For example embryo glue, which is a product that can be used to help the embryo stick to the uterus, is being used. Does it work? Are patients being charged for false hope?

There are some Medicare rebates for IVF procedures in Australia but there is still cost to the patients. So many couples are having over six IVF procedures and still not pregnant. One specialist mentioned a patient went through over 37 IVFs before having a child. Fertility treatments not only cause stress with the cost of IVF but also there’s emotional stress to couples ― depression, guilt, blame ―the list goes on and on. The show, “The Baby Business,” said that a woman at the age of 43 has less than 3% chance of having a live birth. True this was from Australia but the statistics are not far off in other countries. It’s standard knowledge that a women trying to conceive in her 40’s has an extremely low chance of having a live birth with her own eggs. When specialists are asked the main cause of infertility, the answer is “AGE.” Fertility for women starts dropping very quickly at the age of 35. (#AGEMATTERS35)

Society and lifestyles have changed for women but the number of eggs they are born with haven’t changed and as time goes on the quality and number drop.Women go off to college, find work in their careers, travel, etc., but often times delay the time for having children. Unfortunately, many women don’t stop to think about the real meaning of “the clock is ticking,” which is that the perfect time to conceive is between the ages of 18 – 29. Remember: the older the eggs, the harder it is to get pregnant.

The desire to have one’s own biological children can be strong and compelling, the effects of infertility for individuals and couples who are unable to conceive can be devastating. Treatments of infertility can be medically invasive and may cause discomfort or be associated with health problems for women, men and the resulting children.

The CDC has developed the National Public Health Action Plan for the Detection, Prevention and Management of Infertility. Given the goal of public health to reduce disease, premature death, injury and disability through prevention and health promotion, preventing infertility and results associated with its treatment are important concerns.

The plan is to promote healthier behaviors that can maintain fertility. It is also to help educate, promote prevention and early detection and treatment of medical conditions that threaten fertility, reduce exposure to environmental, occupational, and infectious agents that can threaten fertility.(1)

Women need to think of the big picture…….

A large part is to educate our young women when to have their family. I am not saying to run out, find Mr. Right and get pregnant, but keep this all in your mind. In my book, Sperm Tales: An Informative Guide Through the Challenges of Infertility. Inchapter one, When Do I Have My Baby, Now orLater? it reviews an article in Newsweek 2001, about different women who pondered when they wanted to start their families, most of which chose to put it off for several years.

Some were at the height of their careers, others were traveling or going to graduate school. They had no social life and felt that this wasn’t the right time to have children. One woman who was in medical school knew she was pushing the biological time clock. Even so, she felt that the advancement in technology would help her conceive by the time she was ready.

Another woman found her “Mr. Right”at the age of 42 and decided then she wanted to start her family, thinking if movie stars can get pregnant at 40, why can’t I? (Movie stars don’t tell you, there is a good chance they are using donor eggs.) Over the next few years this woman and her husband tried to conceive naturally with no success. They went to a fertility specialist and in time, were able to conceive, but then miscarried. She was devastated. She could not have imagined she would have such a problem conceiving. She asked herself, “What did I do? Did I wait too long to start trying?” To make matters worse, she had spent over $3,000 for the first month of injectable medications.(2)

The general misunderstandings and misguided assumptions about the process are often made worse by the hesitancy of some doctors to mention the topic of age to their younger patients. The above-mentioned Newsweek article highlights that many physicians choose not bring up fertility plans to women under 35 unless the patient herself initiates it. The reasons for this include the idea that some doctors assume that women are aware of the issues related to their fertility or they fear that if it’s brought up might cause them distress or encourage them to make a premature decision to have a child before they are ready. As it is, when a woman visits her OBGYN for the first time the physician usually will ask if the patient is sexually active and if she is using birth control.

In a recent poll, 52% of women over the age of 35 would have made different decisions with better fertility education in their younger years. The new norm is 20% of women having their first baby at 35-45 years of age which has no guarantees and that also includes infertility treatments and higher risks.

Women are very proactive in situations once they have all the major elements to see the big picture, and education is key. My book Sperm Tales: An Informative Guide Through the Challenges of Infertility is an attempt to help patients start an Infertility program on time and to heighten the chance for success, and also to educate young people to keep a clear head about this harsh reality as they plan their lives, families and careers.

In closing, I think it is so important for OBGYN’s to bring up the conversation of fertility or like Resolve said at National Infertility Awareness Week (NIAW) this past April 2016 ― “#Start Asking!”

1 National Public Health Action Plan for the Detection, Prevention and Management of infertility, CDC, June 2014

Lynn M. Collins was trained in the Infertility field at Brigham and Women’s Hospital in Boston, MA and later set up and worked for more than 10 years at an Infertility Lab and Sperm Bank in Massachusetts. Collins draws on her experience as a laboratory supervisor for a leading national sperm bank and manager for a multi-million dollar infertility laboratory. She is the author of Sperm Tales: An Informative Guide Through the Challenges of Infertility, website: http://www.infertility-tales.com/ Lynn lives in New Hampshire with her husband Kevin,black lab Shamus and cat Trapper John.